Cancer and cancer treatments may cause malnutrition.

Cancer and cancer treatments may cause malnutrition.

Cancer and cancer treatments may affect taste, smell, appetite, and the ability to eat enough food or absorb the nutrients from food. This can cause malnutrition, which is a condition caused by a lack of key nutrients. Alcohol abuse and obesity may increase the risk of malnutrition.

Malnutrition can cause the patient to be weak, tired, and unable to fight infection or finish cancer treatment. As a result, malnutrition can decrease the patient's quality of life and become life-threatening. Malnutrition may be made worse if the cancer grows or spreads.

Eating the right amount of protein and calories is important for healing, fighting infection, and having enough energy.


Anorexia and cachexia are common causes of malnutrition in cancer patients.

Anorexia is the loss of appetite or desire to eat. It is a common symptom in patients with cancer. Anorexia may occur early in the disease or later, if the cancer grows or spreads. Some patients already have anorexia when they are diagnosed with cancer. Most patients who have advanced cancer will have anorexia. Anorexia is the most common cause of malnutrition in cancer patients.

Cachexia is a condition marked by weakness, weight loss, and fat and muscle loss. It is common in patients with tumors that affect eating and digestion. It can occur in cancer patients who are eating well, but are not storing fat and muscle because of tumor growth.

Some tumors change the way the body uses certain nutrients. The body's use of protein, carbohydrates, and fat may change when tumors are in the stomach, intestines, or head and neck. A patient may seem to be eating enough, but the body may not be able to absorb all the nutrients from the food.

Cancer patients may have anorexia and cachexia at the same time.


Effects of Cancer Treatment on Nutrition

Key Points

  • Chemotherapy and Hormone Therapy
    • Chemotherapy and hormone therapy affect nutrition in different ways.
    • Chemotherapy and hormone therapy cause different nutrition problems.
  • Radiation Therapy
    • Radiation therapy kills cells in the treatment area.
    • Radiation therapy may affect nutrition.
  • Surgery
    • Surgery increases the body's need for nutrients and energy.
    • Surgery to the head, neck, esophagus, stomach, or intestines may affect nutrition.
  • Immunotherapy
    • Immunotherapy may affect nutrition.
  • Stem Cell Transplant
    • Patients who receive a stem cell transplant have special nutrition needs.

Chemotherapy and Hormone Therapy

Chemotherapy and hormone therapy affect nutrition in different ways.

Chemotherapy affects cells all through the body. Chemotherapy uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Healthy cells that normally grow and divide quickly may also be killed. These include cells in the mouth and digestive tract.

Hormone therapy adds, blocks, or removes hormones. It may be used to slow or stop the growth of certain cancers. Some types of hormone therapy may cause weight gain.

Chemotherapy and hormone therapy cause different nutrition problems.

Side effects from chemotherapy may cause problems with eating and digestion. When more than one chemotherapy drug is given, each drug may cause different side effects or when drugs cause the same side effect, the side effect may be more severe.

The following side effects are common:

  • Loss of appetite.
  • Nausea.
  • Vomiting.
  • Dry mouth.
  • Sores in the mouth or throat.
  • Changes in the way food tastes.
  • Trouble swallowing.
  • Feeling full after eating a small amount of food.
  • Constipation.
  • Diarrhea.

Patients who receive hormone therapy may need changes in their diet to prevent weight gain.

Radiation Therapy

Radiation therapy kills cells in the treatment area.

Radiation therapy kills cancer cells and healthy cells in the treatment area. How severe the side effects are depends on the following:

  • The part of the body that is treated.
  • The total dose of radiation and how it is given.

Radiation therapy may affect nutrition.

Radiation therapy to any part of the digestive system has side effects that cause nutrition problems. Most of the side effects begin two to three weeks after radiation therapy begins and go away a few weeks after it is finished. Some side effects can continue for months or years after treatment ends.

The following are some of the more common side effects:

  • For radiation therapy to the brain or head and neck
    • Loss of appetite.
    • Nausea.
    • Vomiting.
    • Dry mouth or thick saliva. Medication may be given to treat a dry mouth.
    • Sore mouth and gums.
    • Changes in the way food tastes.
    • Trouble swallowing.
    • Pain when swallowing.
    • Being unable to fully open the mouth.

  • For radiation therapy to the chest
    • Loss of appetite.
    • Nausea.
    • Vomiting.
    • Trouble swallowing.
    • Pain when swallowing.
    • Choking or breathing problems caused by changes in the upper esophagus.

  • For radiation therapy to the abdomen, pelvis, or rectum 
    • Nausea.
    • Vomiting.
    • Bowel obstruction.
    • Colitis.
    • Diarrhea.

Radiation therapy may also cause tiredness, which can lead to a decrease in appetite.


Surgery

Surgery increases the body's need for nutrients and energy.

The body needs extra energy and nutrients to heal wounds, fight infection, and recover from surgery. If the patient is malnourished before surgery, it may cause problems during recovery, such as poor healing or infection. For these patients, nutrition care may begin before surgery.

Surgery to the head, neck, esophagus, stomach, or intestines may affect nutrition.

Most cancer patients are treated with surgery. Surgery that removes all or part of certain organs can affect a patient's ability to eat and digest food.

The following are nutrition problems caused by surgery:

  • Loss of appetite.
  • Trouble chewing.
  • Trouble swallowing.
  • Feeling full after eating a small amount of food.

Immunotherapy

Immunotherapy may affect nutrition.

The side effects of immunotherapy are different for each patient and the type of immunotherapy drug given.

The following nutrition problems are common:

  • Tiredness.
  • Fever.
  • Nausea.
  • Vomiting.
  • Diarrhea.

Stem Cell Transplant

Patients who receive a stem cell transplant have special nutrition needs.

Chemotherapy, radiation therapy, and other medicines used before or during a stem cell transplant may cause side effects that keep a patient from eating and digesting food as usual.

Common side effects include the following:

  • Mouth and throat sores.
  • Diarrhea.

Patients who receive a stem cell transplant have a high risk of infection. Chemotherapy or radiation therapy given before the transplant decrease the number of white blood cells, which fight infection. It is important that these patients learn about safe food handling and avoid foods that may cause infection.

After a stem cell transplant, patients are at risk for acute or chronic graft-versus-host disease (GVHD). GVHD may affect the gastrointestinal tract or liver and change the patient's ability to eat or absorb nutrients from food.

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